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Cardiac anaesthesia

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https://www.readbyqxmd.com/read/29773485/pregnancy-after-heterotopic-heart-transplant-removal
#1
S Churchill, L de Lloyd, H C Francis, H Wallis
Heterotopic heart transplants were introduced in 1974. The technique allows the patient's native heart to be preserved in situ, alongside the transplanted heterotopic donor heart (Newcomb et al., 2004). We present the case of a nulliparous woman who underwent heterotopic heart transplant in infancy, and subsequent explantation of the donor heart eleven years later, when her native heart function recovered. In adulthood the patient attended pre-pregnancy counselling and was awaiting cardiac magnetic resonance imaging when she presented pregnant at 6 weeks-of-gestation...
April 24, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29772592/-cardiac-anaesthesia-anaesthesiological-management
#2
Jochen Renner, Berthold Bein, Ole Broch
The anaesthesiological management of patients scheduled for cardiac surgery has been refined distinctively over the last decade due to different reasons. The continuing growth of the elderly patient population and the increasing number of combined cardiac surgery procedures in octogenarians on the one hand are one aspect. The rapid development of minimally invasive cardiac surgery and the enhancements in mechanical, artificial heart assist devices on the other hand can be seen as additional decisive factors...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29769515/complications-following-general-anaesthesia-in-paediatric-patients
#3
A K Khan, S R Quddus, H K Khan, M S Ali, M Kamruzzaman, M R Hasan, M Hasan, R H Moon
Complications in paediatric anaesthesia can be conveniently classified as minor or major. Major morbidity includes cardiac arrest, brain damage and death. Minor morbidity can be assessed by clinical audits with smell patient samples. Major morbidity is rare. It is best assessed by very large clinical studies and by review of cases malpractice claims. Both minor & major complication occurs most commonly in infants and children under three especially those with severe co-morbidities. Knowledge of risk profiles in paediatric anaesthesia is a starting point for the reduction of risk complication...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29761891/processed-electroencephalogram-and-evoked-potential-techniques-for-amelioration-of-postoperative-delirium-and-cognitive-dysfunction-following-non-cardiac-and-non-neurosurgical-procedures-in-adults
#4
REVIEW
Yodying Punjasawadwong, Waraporn Chau-In, Malinee Laopaiboon, Sirivimol Punjasawadwong, Pathomporn Pin-On
BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) may complicate a patient's postoperative recovery in several ways. Monitoring of processed electroencephalogram (EEG) or evoked potential (EP) indices may prevent or minimize POD and POCD, probably through optimization of anaesthetic doses. OBJECTIVES: To assess whether the use of processed EEG or auditory evoked potential (AEP) indices (bispectral index (BIS), narcotrend index, cerebral state index, state entropy and response entropy, patient state index, index of consciousness, A-line autoregressive index, and auditory evoked potentials (AEP index)) as guides to anaesthetic delivery can reduce the risk of POD and POCD in non-cardiac surgical or non-neurosurgical adult patients undergoing general anaesthesia compared with standard practice where only clinical signs are used...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29756694/effects-of-inhalation-and-intravenous-anaesthesia-on-intraoperative-cardiopulmonary-function-and-postoperative-complications-in-patients-undergoing-thoracic-surgery-a-systematic-review-and-meta-analysis
#5
Qian-Yun Pang, Ran An, Hong-Liang Liu
INTRODUCTION: There is a high incidence of postoperative cardiopulmonary complications after thoracic surgery with one lung ventilation (OLV), the effect of general anaesthetics on intraoperative cardiopulmonary function and postoperative complications is still unclear. EVIDENCE ACQUISITION: We searched the Embase, Pubmed, Cochrane Library, Springer, Wiley, CNKI, VIP and Wanfang databases for randomized controlled trials (RCTs) in which inhalation anaesthesia and intravenous anaesthesia were compared; intraoperative cardiopulmonary function and postoperative complications were assessed in patients undergoing thoracic surgery with intraoperative one-lung ventilation (OLV)...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29753669/does-the-weekend-effect-for-postoperative-mortality-stand-up-to-scrutiny-association-for-cardiothoracic-anesthesia-and-critical-care-cohort-study-of-110-728-cardiac-surgical-patients
#6
Olympia Papachristofi, Andrew A Klein, John Mackay, Samer Nashef, Nick S Fletcher, Linda D Sharples
OBJECTIVE: Ongoing debate focuses on whether patients admitted to the hospital on weekends have higher mortality than those admitted on weekdays. Whether this apparent "weekend effect" reflects differing patient risk, care quality differences, or inadequate adjustment for risk during analysis remains unclear. This study aimed to examine the existence of a "weekend effect" for risk-adjusted in-hospital mortality after cardiac surgery. DESIGN: Retrospective analysis of prospectively collected cardiac registry data...
April 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29740019/feasibility-and-safety-of-using-local-anaesthesia-with-conscious-sedation-during-complex-cardiac-implantable-electronic-device-procedures
#7
Elif Kaya, Hendrik Südkamp, Julia Lortz, Tienush Rassaf, Rolf Alexander Jánosi
We assessed the feasibility and safety of using local anaesthesia with conscious sedation as an alternative to general anaesthesia during complex and noncomplex cardiac implantable device procedures. We enrolled 279 consecutive patients who underwent cardiac device implantation/replacement at our tertiary/quaternary cardiac specialist hospital during a 17-month study period. Continuous combined intravenous conscious sedation with propofol and midazolam plus fentanyl and local anaesthesia were used for all procedures...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29721645/midazolam-increases-preload-dependency-during-endotoxic-shock-in-rabbits-by-affecting-venous-vascular-tone
#8
Jianxiao Chen, Tao Yu, Federico Longhini, Xiwen Zhang, Songqiao Liu, Ling Liu, Yi Yang, Haibo Qiu
BACKGROUND: Septic patients often require sedation in intensive care unit, and midazolam is one of the most frequently used sedatives among them. But the interaction between midazolam and septic shock is not known. The aim of this study is to investigate the effects of midazolam on preload dependency in an endotoxic shock model by evaluating systemic vascular tone and cardiac function. METHODS: Eighteen rabbits were randomly divided into three groups: Control group, MID1 group and MID2 group...
May 2, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29701428/anaesthetic-management-in-a-duchennne-muscle-dystrophy-patient-for-treatment-of-recurrent-pneumothorax
#9
Sara Mota, Liuba Germanova, Joana Cortesão, Teresa Paiva
INTRODUCTION: Duchenne muscular dystrophy (DMD) is an x linked recessive disorder. Long term prognosis is ominous, with development of respiratory distress and cardiomyopathy in advanced stage of the disease and expected death in the teens-to-mid 20s due to respiratory or cardiac failure. Peri-operative management of this patients is challenging due to difficult airway anatomy (macroglossia, limited neck and mandibular mobility). Additionally, they are at risk of developing malignant hyperthermia, rhabdomyolysis and hyperkalemic cardiac arrest when exposed to halogenated inhalational anaesthetics and depolarizing muscle relaxants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701425/analgesia-management-for-mitral-valve-repair-via-minithoracotomy-a-case-report
#10
Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701424/perioperative-family-centered-care-nursing-interventions-that-support-child-and-family-s-emotional-management
#11
Dario Antunes, Paula Diogo
INTRODUCTION: Hospitalization is a negative tonality experience for both child and family, being fear and anxiety their emotional mirror. Concerning the surgical experience, the environment, invasiveness, fear of pain, of not waking up from anaesthesia and parental separation are both causes and enhancers of child and family perioperative distress. A study concerning parent's emotional experience of child's submitted to cardiac surgery, refer guilt for their son's cardiopathy, a roller coaster of emotions, impotence and being seated on pins and needles while waiting during the surgery...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701421/rapid-pacing-for-thoracic-endovascular-aortic-repair-a-case-report
#12
Hugo Silva, Andreia Fernandes, João Rodrigues, Daniel Brandão, Manuela Vieira, Catarina Celestino
INTRODUCTION: Endovascular aortic interventions are suitable alternatives to open surgery, being less invasive and having lower mortality and complications. Accurate positioning of the stent graft is a critical point because of systolic thrush. Techniques used to prevent it include pharmacological (antihypertensive drugs, nitroglycerin, adenosine) and mechanical methods (temporary caval occlusion by balloon). Rapid Right Ventricular Pacing (RRVP) is an emerging alternative with good patient tolerance and low level of complications...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29694674/local-anaesthetics-and-regional-anaesthesia-versus-conventional-analgesia-for-preventing-persistent-postoperative-pain-in-adults-and-children
#13
REVIEW
Erica J Weinstein, Jacob L Levene, Marc S Cohen, Doerthe A Andreae, Jerry Y Chao, Matthew Johnson, Charles B Hall, Michael H Andreae
BACKGROUND: Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition. This review was originally published in 2012 and updated in 2017. OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of PPP beyond three months in adults and children undergoing elective surgery. SEARCH METHODS: We searched CENTRAL, MEDLINE, and Embase to December 2016 without any language restriction...
April 25, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29680809/impact-of-dexmedetomidine-infusion-during-general-anaesthesia-on-incidence-of-postoperative-delirium-in-elderly-patients-after-major-non-cardiac-surgery-study-protocol-of-a-randomised-double-blinded-and-placebo-controlled-trial
#14
Bo-Jie Wang, Chun-Jing Li, Jian Hu, Huai-Jin Li, Chao Guo, Zhen-Han Wang, Qiao-Chu Zhang, Dong-Liang Mu, Dong-Xin Wang
INTRODUCTION: Delirium is a common complication in the elderly after surgery and is associated with worse outcomes. Multiple risk factors are related with postoperative delirium, such as exposure to general anaesthetics, pain and postoperative inflammatory response. Preclinical and clinical studies have shown that dexmedetomidine attenuated neurotoxicity induced by general anaesthetics, improved postoperative analgesia and inhibited inflammatory response after surgery. Several studies found that intraoperative use of dexmedetomidine can prevent postoperative delirium, but data were inconsistent...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29670189/preoperative-red-cell-distribution-width-and-30-day-mortality-in-older-patients-undergoing-non-cardiac-surgery-a-retrospective-cohort-observational-study
#15
H R Abdullah, Y E Sim, Y T Sim, A L Ang, Y H Chan, T Richards, B C Ong
Increased red cell distribution width (RDW) is associated with poorer outcomes in various patient populations. We investigated the association between preoperative RDW and anaemia on 30-day postoperative mortality among elderly patients undergoing non-cardiac surgery. Medical records of 24,579 patients aged 65 and older who underwent surgery under anaesthesia between 1 January 2012 and 31 October 2016 were retrospectively analysed. Patients who died within 30 days had higher median RDW (15.0%) than those who were alive (13...
April 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29664117/perioperative-hyperoxia-and-post-operative-cardiac-complications-in-adults-undergoing-non-cardiac-surgery-systematic-review-protocol
#16
REVIEW
C Petersen, J Wetterslev, C S Meyhoff
BACKGROUND: Oxygen therapy is used liberally for all patients undergoing anaesthesia. Recent studies have raised concerns that it may not be without complications when arterial oxygen concentrations reach supranormal concentrations (hyperoxia). Studies of oxygen therapy have raised concerns that the risk of myocardial injury and infarction is elevated in patients with hyperoxia due to vasoconstriction and formation of reactive oxygen species. Due to lack of symptoms or silent ischaemia, post-operative myocardial injury may be missed clinically...
April 17, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29655977/dexmedetomidine-or-fentanyl-cardiovascular-stability-and-analgesia-during-propofol-ketamine-total-intravenous-anaesthesia-in-experimental-pigs
#17
Andreas Lervik, Joanna Raszplewicz, Birgit Ranheim, Susanna Solbak, Simen F Toverud, Henning A Haga
OBJECTIVE: To compare cardiovascular function and response to nociception during total intravenous anaesthesia in pigs with propofol, ketamine and either dexmedetomidine or fentanyl administered as a continuous infusion. STUDY DESIGN: Blinded, randomized, balanced, crossover study ANIMALS: Eight immunocastrated male, mixed breed pigs with a mean ± standard deviation body weight of 26.4 ± 1.9 kg for dexmedetomidine and 27.5 ± 3.8 kg for fentanyl treatment...
May 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29627630/awake-intradural-spinal-tumour-resection
#18
Anan Shtaya, Chan Bao Luong, Erlick Pereira
BACKGROUND: Meningioma is a common slow growing spinal tumour with a predilection for intradural occurrence. Patients usually present with pain followed by ataxia and sensory and sphincter problems. The gold standard treatment in these cases is gross total microsurgical resection under general anaesthesia. However, there exist high anaesthetic risk patients unsuitable for general anaesthesia. Performing spinal surgeries under local anaesthesia and sedation has been reported albeit rarely for mostly minimally invasive procedures but not for open intradural pathologies...
April 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29625498/platelet-inhibition-and-bleeding-in-patients-undergoing-non-cardiac-surgery-the-bianca-observational-study
#19
Elisabeth Mahla, Helfried Metzler, Helmar Bornemann-Cimenti, Florian Prueller, Reinhard B Raggam, Gudrun Pregartner, Andrea Berghold, Anneliese Baumann, Christian Goeroeg, Paul A Gurbel
Nearly 20% of patients will need non-cardiac surgery within 1 year of coronary stenting and their management is complicated by concomitant antiplatelet therapy. Platelet function testing may optimize the timing of surgery in these patients. In this prospective observational study, we explored the association between platelet reactivity and bleeding in patients undergoing non-cardiac surgery treated with clopidogrel with or without aspirin within 7 days before surgery. The timing of surgery was at the surgeon's discretion...
April 6, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29623224/spinal-anaesthesia-for-cesarean-section-in-a-patient-with-vascular-type-ehlers-danlos-syndrome
#20
Jeffrey M Carness, Mark J Lenart
We report the administration of spinal anaesthesia for cesarean delivery in a parturient with vascular Ehlers-Danlos syndrome. Parturients who genetically inherit this disorder are at risk for significant morbidity and mortality. Risks during pregnancy include premature labor, uterine prolapse, and uterine rupture. Additionally, such laboring parturients are at increased risk of hemodynamic volatility, vascular stress, and severe postpartum hemorrhage. Instrumented delivery and cesarean delivery bring additional risks...
2018: Case Reports in Anesthesiology
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